Fat Grafting Candidate With Extremely Thin Skin Under Eye?

Question

I have fair, thin and translucent skin under my eye, but have hollowing I would like to fix with fat grafting. Is it possible to have a good outcome in someone with super thin skin. Will the fat show through my see through skin?

Tim Neavin, MD · Answer

Thank you for your question and for your photos. Based on your photos provided, you are an ideal candidate for facial fat grafting. I would advise you to schedule a consultation with a board certified plastic surgeon for a detailed examination to discuss all possible treatment options and what your expectations are.

Thomas Fiala, MD, FACS, FRCSC · Answer

This is a very challenging area to treat with fat grafting.  There's little margin for error here, and any lumpiness or irregularity in the fat grafting, even in the best of hands, may show.

	If you were my sister, I'd probably tell you to use a hyaluronic gel product, rather than fat grafting.  That way, if you don't like the result, it can be "erased" with an injection of hyaluronidase enzyme.

	 

	All the best,

Eric M. Joseph, MD · Answer

I read your concern:

	In my practice, Silikon-1000, an off-label filler for permanent results, may be used to correct lower eyelid hollowing. Thin skin may increase your risk of bruising or experiencing visible product at your injection site.

	I hope this is helpful for you.

	Dr. Joseph

Kenneth D. Steinsapir, MD · Answer

Please do not let someone experiment on your eyelids. We know the end result. Lumps, bumps and much unhappiness. Fat grafting the lower eyelid is not a great procedure to begin with. The key for it to even remotely work is the ability to hide grafted fat under thicker skin and in fat layers. If you have thin skin and a think lower eyelid, no matter how good those Newport Beach surgeons are at blowing smoke in your direction, you are have very high risk of having an unsatisfactory result. That is probably why you are posting on this site. Somewhere in your brain you know this sounds too good to be true. Please listen to that intutition.

Philip Young, MD · Answer

Fat grafting can be great for you. The thin skin can sometimes make the results more difficult to achieve. But you have to either accept the thin hollow lower eyelid skin or go with the fat grafting. Fat grafting can be done with this anatomy and you can get great results. But I would go to someone with experience.

Mark D. Wigod, MD · Answer

I am a big fan of fat grafting, but under thin skin in the infra orbital position is quite risky for visible grafts. There are worse things than looking older, so I am very careful around that anatomic area.

Samir Shureih, MD · Answer

Fat grafting to the hollow eyes and tear trough require expertise and finness. Must use micro fat grafting (I use the small infiltration canula to harvest micro fat grafts)

	The fat should be put right on top of the bone , under the muscle and should avoid putting any with in the muscleInjected in small packets of fat with a special injector tool can give you the desired effect even if you have thin skin.

Brooke R. Seckel, MD, FACS (retired) · Answer

Filler injections in Thin Eyelid Skin can cause lumps and visible grey irregularities and should be avoided.

	Fat grafting of an intact Fat Graft under direct vision during a Transconjunctival Blepharoplasty with Arcus Marginalis Release plumps the hollow eye and lessens the shadow and reduces the translucent appearance of the thin skin.

	The graft is placed beneath the eyelid muscle and septum so irregularities are less likely than with filler injections which are difficult to place accurately.

	See link below for more information.

Francis R. Palmer, III, MD (retired) · Answer

No, not IMHO. Fat grafting is still unreliable and there's no way to predict how much will remain after it's injected. In very thin skin, the fat can appear lumpy and bumpy. I'd suggest tryiing a reliable soft tissue filler that's realtively thin preferably placed through the lower eyelid to avoid the superficial vessels just below the skin. Restylane or Juvederm would be ny first choice.

Richard Ellenbogen, MD (retired) · Answer

Fat grafting is certainly a powerful tool to reshape the face. You are correct to be concerned about placing fat in areas where the skin is thin. Contouring in the infraorbital region requires significant experience and judgment. I suggest you visit a plastic surgeon who has experience in this area to find out if you are a candidate. I have found that very few patients have skin so thin that they cannot benefit from fat grafting in the infraorbital region.

Fat Grafting Candidate With Extremely Thin Skin Under Eye?

Answers (12)

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